Study Suggests Limited Efficacy of OTC Meds for Chronic Idiopathic Constipation

Results showed that the majority of patients expressed dissatisfaction with the effect of the OTC agent on constipation and CIC-specific abdominal symptoms.

When establishing a treatment plan for patients with chronic idiopathic constipation (CIC), it is important for health care providers to consider the effects of therapy on individual symptoms and bowel habit predictability, as well as overall patient satisfaction, according to a recently published post-hoc analysis.

Although CIC is highly prevalent among US adults and significantly impacts quality of life as well as health care costs, information on patient experiences with over the counter (OTC) medication is limited. “The goal of this analysis was to use patient-reported questionnaire data from screening for a prospective phase 3b clinical trial to help understand the experiences of patients with CIC in using OTC medications over the preceding 6 months,” the study authors explained.  

Patients who were screened (N=1482) were asked to complete a Prior Medication Questionnaire (PMQ), which assessed OTC medication use for the treatment of CIC over the previous 6 months. A total of 1423 patients provided responses to the PMQ and were included in the analysis. The average age of patients included was 48.9 years; 85% were female and 66% were white.

“A high proportion of patients had used 1 or more OTC medications (70% had ≥1 OTC; 19% had ≥3 OTCs), with the majority being bisacodyl (33%) and polyethylene glycol (30%),” the study authors reported. Findings of the analysis also revealed insufficient symptom relief to be the most commonly cited reason for discontinuing an OTC agent (reported by 17-40% of patients across medications).

Results showed that the majority of patients expressed dissatisfaction with the effect of the OTC agent on constipation (62%) as well as CIC-specific abdominal symptoms (78%). The analysis also revealed that 49-81% of patients reported not being at all confident regarding their ability to predict the timing of bowel movements (BMs) after taking OTC medications. Additionally, many patients also said they had little or no confidence in the frequency of BM after administering OTC medications.

“For the majority of OTC medications, patients report no or little satisfaction with the medication’s effect on their constipation and abdominal symptoms,” the authors concluded. They added, “These are important factors for health care providers and patients to consider when establishing a treatment strategy for CIC.”

Disclosure: Multiple authors declared conflicts of interest. Please refer to the original article for a full list of disclosures.


Lacy BE, Shea EP, Manuel M, Abel JL, Jiang H, Taylor DCA. Lessons learned: Chronic idiopathic constipation patient experiences with over-the-counter medications. PLoS ONE. 2021; 16(1): e0243318.